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髋关节表面置换术中的计算机导航经验可使用传统夹具改善股骨部件的对线。

Computer navigation experience in hip resurfacing improves femoral component alignment using a conventional jig.

作者信息

Morison Zachary, Mehra Akshay, Olsen Michael, Donnelly Michael, Schemitsch Emil

机构信息

Department of Orthopaedic Surgery, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.

出版信息

Indian J Orthop. 2013 Nov;47(6):585-90. doi: 10.4103/0019-5413.121585.

DOI:10.4103/0019-5413.121585
PMID:24379464
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3868140/
Abstract

BACKGROUND

The use of computer navigation has been shown to improve the accuracy of femoral component placement compared to conventional instrumentation in hip resurfacing. Whether exposure to computer navigation improves accuracy when the procedure is subsequently performed with conventional instrumentation without navigation has not been explored. We examined whether femoral component alignment utilizing a conventional jig improves following experience with the use of imageless computer navigation for hip resurfacing.

MATERIALS AND METHODS

Between December 2004 and December 2008, 213 consecutive hip resurfacings were performed by a single surgeon. The first 17 (Cohort 1) and the last 9 (Cohort 2) hip resurfacings were performed using a conventional guidewire alignment jig. In 187 cases, the femoral component was implanted using the imageless computer navigation. Cohorts 1 and 2 were compared for femoral component alignment accuracy.

RESULTS

All components in Cohort 2 achieved the position determined by the preoperative plan. The mean deviation of the stem-shaft angle (SSA) from the preoperatively planned target position was 2.2° in Cohort 2 and 5.6° in Cohort 1 (P = 0.01). Four implants in Cohort 1 were positioned at least 10° varus compared to the target SSA position and another four were retroverted.

CONCLUSIONS

Femoral component placement utilizing conventional instrumentation may be more accurate following experience using imageless computer navigation.

摘要

背景

与传统器械相比，计算机导航技术已被证明可提高髋关节表面置换术中股骨假体植入的准确性。然而，在后续使用无导航的传统器械进行手术时，接触计算机导航是否能提高准确性尚未得到研究。我们研究了在无影像计算机导航辅助下进行髋关节表面置换后，使用传统夹具进行股骨假体对线是否会更准确。

材料与方法

2004年12月至2008年12月期间，由一名外科医生连续进行了213例髋关节表面置换手术。前17例（队列1）和后9例（队列2）使用传统导丝对线夹具进行髋关节表面置换。187例使用无影像计算机导航植入股骨假体。比较队列1和队列2中股骨假体对线的准确性。

结果

队列2中的所有假体均达到术前计划确定的位置。队列2中假体柄-轴角（SSA）与术前计划目标位置的平均偏差为2.2°，队列1为5.6°（P = 0.01）。队列1中有4个假体相对于目标SSA位置内翻至少10°，另有4个假体向后倾斜。

结论

在使用无影像计算机导航获得经验后，使用传统器械进行股骨假体植入可能会更准确。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/224e/3868140/3f0eef39406b/IJOrtho-47-585-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/224e/3868140/9984a875796c/IJOrtho-47-585-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/224e/3868140/5e31c5161e75/IJOrtho-47-585-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/224e/3868140/4a9930b1decf/IJOrtho-47-585-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/224e/3868140/542e7216111f/IJOrtho-47-585-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/224e/3868140/3f0eef39406b/IJOrtho-47-585-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/224e/3868140/9984a875796c/IJOrtho-47-585-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/224e/3868140/5e31c5161e75/IJOrtho-47-585-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/224e/3868140/4a9930b1decf/IJOrtho-47-585-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/224e/3868140/542e7216111f/IJOrtho-47-585-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/224e/3868140/3f0eef39406b/IJOrtho-47-585-g005.jpg

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本文引用的文献

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2
The effect of patient selection and surgical technique on the results of Conserve® Plus hip resurfacing--3.5- to 14-year follow-up.患者选择和手术技术对Conserve® Plus髋关节表面置换术结果的影响——3.5至14年随访
Orthop Clin North Am. 2011 Apr;42(2):133-42, vii. doi: 10.1016/j.ocl.2010.12.005.
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Avoiding short-term femoral neck fracture with imageless computer navigation for hip resurfacing.
避免髋关节表面置换术中无影像计算机导航的股骨颈骨折。
Clin Orthop Relat Res. 2011 Jun;469(6):1621-6. doi: 10.1007/s11999-010-1607-y.
4
A comparison of conventional guidewire alignment jigs with imageless computer navigation in hip resurfacing arthroplasty.常规导丝定位夹具与无影像计算机导航在髋关节表面置换术中的比较。
J Bone Joint Surg Am. 2010 Aug 4;92(9):1834-41. doi: 10.2106/JBJS.I.00648.
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The biomechanical consequence of insufficient femoral component lateralization and exposed cancellous bone in hip resurfacing arthroplasty.髋关节表面置换术中股骨部件侧方移位不足及松质骨暴露的生物力学后果。
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What is the midterm survivorship and function after hip resurfacing?髋关节表面置换术后中期生存率和功能如何？
Clin Orthop Relat Res. 2010 Dec;468(12):3221-7. doi: 10.1007/s11999-010-1438-x.
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Comput Aided Surg. 2009;14(4-6):117-22. doi: 10.3109/10929080903444440.
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The learning curve for adopting hip resurfacing among hip specialists.髋关节专家采用髋关节表面置换术的学习曲线。
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